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STATE OF FLARIDA 3442 i
FOG FORM LCT •~s DgppRTMBNT OF COMMERCB
~REV. ~ns~ DN~ION OF EMPLOYMENT SECURITY
TALLAHASSEE 32304 Account No. 21.1588 Q
Licn No. ~+-2241~ -
NOTICE OF TAX LIEN
Pursuanc to the provisions of Section 443.15 (3) ~a), Florida Statutes, knoa~ as the Florida Un-
employment Compensation law, notice is hereby given that there have. been assessed~ pursuant co che
provisions of said law~ against Jose~h L Carter T/A Men's Den Roofing u$ •
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Ft Pierce, Florida 33450 _ ~
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an "employer" liable for the payment of contribucions co" the Unemploymenc Compensation Fund of
Florida, pursuant to the provisions of said law, the sum of E lih3 S~ covering the following
contributions, iaterest and penalties, which after demand for payment thereof remain unpaid, anJ
chat by vircue of the above mentioned law the amount of said concributions (caxes), cogecher wich
penalties, inceresc, and costs chat may accrue in addicion chereto, conscicute a lien i~ Eavor of State ot
Florida DepsNment ot Commerccupon the citle to and interest, whecher legal or equitable; in any real
property, chattels real, or personal property of said employer. ~
Periods for which contributions, interest, and penalties have been assessed, and the amounts
chereof, are as follows:
E -
~ INTEREST THROUGH
PERIOD CQNTRIBUTIONS PENALTIES
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lst Quarter 197 Supp. 15~+ 07 3 85
2ad Quarter~l97 23$ 26 2 38 5 00
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TOTAL 3 2 33 6 23 5 00
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WITNESS THE OF'FICIAL SEAL OF' TNE STATE OF FLORIDA DEPARTMENT OF COMMERCE
•nd the hand of the Direcbr oi ihe Division of Employment Security thereot. at Tallahassee. Fiorida,
ihie~day of c~ t n~ P r A. D. 19 7~+
• - 293442
~`~t STATE OF FLORIDA
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` • IlOCE
CPOi1RAt
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~ RFt•ORO VERtFtEO
'~1ye~lus~ameni pO~pd by:
3=' ~'i Oc~ I~i t2 PM'7~1
am
DE~1aT~O1CAt Ott 41IIlEfCe D~RECTOR. O~VISION OF
EMPLOYMENT SECURITY
Caldwell Bld Tallahassee. F'la• Q R~~p i
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